NPI 1508107665

Edward Victor Small, PTA

Practitioner Physical Therapy Assistant Bangor, ME

Practice location

Address: 489 State St, Bangor, ME 04401-6616
Phone: (207) 973-8086
Mailing address: 297 Birch St, Bangor, ME 04401-4025

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence PA3405 (ME)

Other Physical Therapy Assistant providers in Maine →

Registry record

NPI: 1508107665
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Mar 2013
Record last updated: 13 Mar 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.